Newsletter. Ageing and Development. In Latin America and the Caribbean. March, Karoline Schmid Caribbean challenges of a global phenomenon

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1 DIVISION OF AGEING, TRINIDAD&TOBAGO March, 2006 Newsletter Ageing and Development In Latin America and the Caribbean Karoline Schmid Caribbean challenges of a global phenomenon Harold Robinson Information is the basis for effective action Implementation of the Regional Strategy Caribbean steps towards a society for all ages Montevideo: ECLAC called the attention of countries on social protection

2 ECLAC PORT OF SPAIN Karoline Schmid Caribbean challenges of a global phenomenon Population Affairs Officer at the ECLAC Sub-regional Headquarters for the Caribbean. NEWSLETTER AGEING AND DEVELOPMENT NUMBER 3, MARCH 2006 Latin American and Caribbean Demographic Centre (CELADE)- Population Division of ECLAC Director Dirk Jaspers-Faijer Coordinator José Miguel Guzmán Production Karoline Schmid Lauren Legall Mónica Cuevas Editor Mónica Cuevas Contact boletin.envejecimiento@cepal.org This newsletter was prepared by the Latin American and Caribbean Demographic Centre (CELADE)-Population Division of ECLAC and the ECLAC Sub-regional Headquarters for the Caribbean, in cooperation with the other members of the Inter-Institutional Group on Ageing: United Nations Population Fund (UNFPA), United Nations Program on Ageing, Pan American Health Organization (PAHO), Inter-American Development Bank (IDB), International Labour Organization (ILO) and the World Bank. Produced with financial support from the UNFPA The views expressed in this document, which has been reproduced without formal editing, are those of the authors and do not necessarily reflect the views of the organization. A vailable data show that the Caribbean is one of the fastest ageing regions in the world and it is expected that over the next 50 years, almost all of its countries will experience at least a doubling of the percentage of persons over age 60. Already relatively advanced are Barbados, Cuba and Puerto Rico whereas Haiti, Belize, the Dominican Republic and Guyana still have rather young populations. In expression of its commitment to strengthen the region in its capacity to respond to these challenges, the ECLAC Sub-regional Headquarters for the Caribbean has embarked on various initiatives. These include the publication of two studies on population ageing in the Caribbean and the support of the First Caribbean Symposium on Population Ageing, an intergovernmental meeting convened in Port of Spain, Trinidad and Tobago in November The first day of this event was devoted to academic research on population ageing in the Caribbean while the second and third day provided a platform for Of critical importance to the region are issues related to ageing and economic and social security, health care, housing, transport and living conditions and the establishment of a legal framework to regulate various aspects affecting the lives of the elderly. governments to share best practices and to identify gaps in their efforts to address population ageing in their respective countries. An expert panel composed of professionals from across the region and internationally, provided insight into critical issues in ageing from a regional and global perspective. Of critical importance to the region are issues related to ageing and economic and social security, health care, housing, transport and living conditions and the establishment of a legal framework to regulate various aspects affecting the lives of the elderly. Further, the meeting expressed a definitive need to recognize gender specific aspects in ageing and to work towards enhancing intergenerational solidarity at the country level. To fill these gaps, it was suggested to set up a Caribbean Ageing Network as a mechanism to share best practices and to develop modalities for south-south cooperation. The academia present suggested the establishment of a resource center to share and coordinate research on ageing in the region. Accepting an invitation by the University of the West Indies in early 2005, the ECLAC sub-regional Headquarters has been serving at the national team of Trinidad and Tobago to implement phase III of the Integrated Response of Health Care Systems to Rapid Population Ageing (INTRA). The ECLAC Sub-regional Headquarters reiterates its commitment to support this and other initiatives of the Caribbean countries in their thrive to implement pledges made at global and regional gatherings to make growing older a happy, healthy and enjoyable experience for all peoples in the region.

3 Harold Robinson Information is the basis for effective action Representative of the United Nations Population Fund (UNFPA) for the Englishand Dutch-speaking Caribbean. UNFPA T o mainstream the perspective of the human life cycle into development processes, with a special emphasis on the poorest older adult population, has been a constant objective of the United Nations Population Fund (UNFPA) in the Englishand Dutch-speaking Caribbean nations. The possibility of carrying forward this objective, which arose from the second World Assembly on Ageing (Madrid, 2002) and from the Regional Strategy (Santiago 2003), depends to a great extent on the availability of data on the situation of the elderly in the countries concerned. It is impossible to build responses to their needs into general public policies and into plans and programmes to deal with the social demands of ageing unless sufficient and reliable information is available. In much of the Caribbean, the absence of data on the implications of the ageing process and on the situation of older adults has been an obstacle to the preparation and implementation of strategies to improve this population group s quality of life and to the promotion of their rights. UNFPA has undertaken an active role in this regard, conducting situation analyses in Belize, Suriname, Saint Lucia, and Guyana. Similar activities have been planned for Jamaica and for Trinidad and Tobago. All these countries constitute priorities for UNFPA work in the subregion. The results of these analyses have formed the basis for an initial appraisal of the situation of the elderly in those countries, but more in-depth work is needed. Using this information, UNFPA organized roundtable meetings during 2005 in Belize, Guyana and Saint Lucia, as a starting point for the different stakeholders to discuss policy proposals. It is hoped to extend these activities to Suriname, Trinidad and Tobago and Jamaica during The compilation of data for a better understanding of the conditions in which the region s elderly live is a key component of a whole range of processes directed at convincing the decision makers to mainstream the ageing perspective into public policies. Another key part of this is involving older persons in actions to lay the groundwork for the society for all ages to which we aspire. UNFPA has adopted the United Nations The compilation of data about the conditions in which the region s elderly live and manage their lives is a key component to mainstream the ageing perspective into public policies. approach of encouraging the greatest possible participation of the different stakeholders in a bottom-up strategy to oversee progress in the implementation of the Madrid International Plan of Action on Ageing. This approach is designed to incorporate the views of older people and will be an essential part of the review of the Plan to be conducted in From this forum, UNFPA reiterates its standing offer to work collaboratively with governments and regional institutions that share these objectives, as well as agencies of the United Nations system. All are encouraged to devise creative ways to make the most of the tremendous human capital represented by the elderly and foster their participation in society. PUBLICACIONES Living arrangements of older persons around the world A first global survey and analysis on the patterns and trends in the living arrangements of older persons. It presents data for more than 130 countries. Department of Economic and Social Affairs, Population Division United Nations, publications/livingarrangement/rep ort.htm Ageing: Discussing the issue in Trinidad A look into the main points on debate about ageing topics in the island. Joan Rawlins University of the West Indies, St. Augustine, Trinidad Health, well-being, and ageing in Latin America and the Caribbean A special edition of the Pan American Journal of Public Health focused on different ageing issues in the region. Pan American Health Organization Vol.17. May-June 2005 Adultos mayores en plenitud: riqueza de vida Interviews to sixteen Chilean older persons who play important roles in different social scopes. Macarena Moreno Servicio Nacional del Adulto Mayor, Gobierno de Chile, 2005.

4 COUNTRIES IN ACTION DIVISION OF AGEING, TRINIDAD&TOBAGO Implementation of the Regional Strategy: Caribbean steps towards a society for all ages The countries of this subregion are trying to face the demographic challenges with an inclusive and holistic approach. rising out of the Second World Assembly on Ageing in 2002, the Regional Intergovernmental Conference on Ageing for Latin America and the Caribbean in 2003, the adoption of the Caribbean Regional Charter on Ageing in 1999 by the Caribbean Community and the Caribbean Symposium on Population Ageing in 2004, a number of Caribbean countries have committed to acknowledge ageing as an issue of priority in the areas of health and social planning. Over the last decade, the Governments of these countries have embarked on individual and regional initiatives, to ensure that each nation has the necessary infrastructure to deal with the dramatic changes in demographics expected over the next 10 to 25 years. The approach has been all inclusive and holistic, focusing on themes including intergenerational solidarity, employment, social security, health and well-being and social inclusion. However, given that the demographic transition varies from country to country, the degree of progress also varies considerably between nations. The progress of ten of these Caribbean countries, with respect to the development of policies, initiatives and the establishment of programmes is highlighted in this section. Further information about the achievements of the countries in our online version: ANTIGUA & BARBUDA Brightening the lives of the elderly A draft National Policy for the Elderly was produced by the Social Improvement Sector of the Ministry of Health in Antigua in Prior to that, in 1995, there was an amendment to the Social Security Act of This resulted in a non-contributory pension scheme designed to provide financial assistance to older persons who previously would not have qualified, because they did not contribute to the Social Security Scheme during their working life. The Government, through the Citizens Welfare Division, has also developed programmes to address the social needs of the vulnerable elderly, by filling the gaps in service to relieve loneliness and the stress of ageing. One such programme is the Welfare Aides Service which provides facilities and services aimed at fulfilling the recreational, social and emotional needs of the elderly population. Housebound elderly with physical limitations also receive social assistance through the Home Help Service. This organization ensures the provision of assistance with domestic activities in their homes, which allows the elderly to stay in familiar environments. Additional services are provided by two active non-government organizations, the Antigua & Barbuda Pensioners Association, which is actively engaged in discussions with the Government to provide additional medical, social and financial benefits for the older population and the Senior Citizens Association. ARUBA Committed to autonomy The Aruban Government has committed to an immediate plan of action to assist the elderly in remaining autonomous for as long as possible in their environments, while fully developing their potential and contributing actively to society. To this end, a number of objectives have been identified and a commitment has been made to carry out the necessary studies to guarantee the solvency of existing social security systems. The Government has recognized that the present social infrastructure will not support the demographic transition expected over the next 10 to 20 years. An alternative organizational structure is proposed, with emphasis on a continuum of care between the home, institutional and community based long-term care and relevant welfare institutions, as well as a focusing of resources on the needs of older persons, including long term care and assistance and treatment of chronic diseases. This action plan also seeks to guarantee income security for the elderly now and in the future. The Aruban Government has adopted an official old-age pension programme, designed to ensure a minimum income for the elderly. There is also a plan to promote health and well-being in old age by focusing on the preventive aspect of health and medical care and by encouraging the active participation of the older population in the social mainstream. ntigua & Barbuda ruba ntigua & Barbuda ntigua & Barbuda ruba ruba

5 COUNTRIES IN ACTION DIVISION OF AGEING, TRINIDAD&TOBAGO BAHAMAS A network for health In 1999 a National Council on Older Persons was established in acknowledgement of ageing as an issue of priority. The areas of health and social planning were of particular importance given that medical and social services are essential to the well being of the elderly. A number of policies already exist in the Bahamas, with more recent programmes established to cater to the needs of the older population. Health care is widely available through a network of community clinics and hospitals to all persons aged 60 and over. Medication is provided free of charge to persons over age 65 at Government hospitals, while a 10% discount is offered to elders at several private pharmacies. In addition, home health care is available through district nursing services. The Government provides partial salary replacement during illness, as well as disability and death benefits. Since 1972, all insured persons over 65 years of age are entitled to retirement benefits, and receive a pension according to their particular contributions. An Old Age Non-Contributory Pension in the amount of 200 dollars has been introduced to those older persons who have not made any or sufficient contributions. Over the last six years various private and public residential care and assisted living facilities have become available to older persons. The Government has since enacted legislation to regulate these facilities to ensure appropriate quality standards. BARBADOS Working for social inclusion In 1975 Barbados became the first Caribbean country with more than 10% of its population being elderly. In 2001 the Government established the draft of the National Policy on Ageing under the Ministry of Social Transformation and a Committee appointed to review the proposals for submission to Cabinet. A number of programs have since been implemented through the 2003 Occupational Pensions Benefits Act to ensure that the elderly can maintain their economic independence. One such provision is the establishment of universal pension coverage through contributory and non-contributory pensions paid to persons aged 65 and over. The Government has also embarked on an initiative to provide universal health care and medication services to all people aged 60 and over. Health service delivery has been divided into seven program areas, two of which focus specifically on the older population. There are also plans to create a program to facilitate accommodation needs for the ill elderly. The social inclusion of the aged population is another priority area which has been targeted in Barbados by the construction of a number of recreational centers where the elderly can go to get involved in craft, exercise programmes and other social activities. In 2002 the Government began the construction of the Vauxhall Senior Citizen Village Complex which will have three segments, residential, recreational and day care. DOMINICA Planning for the future A National Policy on Ageing was developed and adopted by the Government in October The goal of the policy is to ensure that older persons will be provided with protection, care and opportunity to participate in the development of the nation. The National Health Plan addresses the needs of the elderly over age 60 as a priority area. Included in the plan is the provision of free basic health care, including medication and home care delivery, through an island-wide network of clinics. In addition, specialist services in mental health and ophthalmology care are offered and routine hypertension and diabetic tests are conducted in all communities. Prior to this, since the early 1990 s, the curriculum of the Nursing School has included a module for care for the elderly and since 1997 the Dominica Council on Ageing has been providing training for informal community care givers. There are a number of planned future activities including public awareness programs, development of standards of care and implementation of follow-up on the Regional Strategy of the Madrid Plan of Action. Dominica ahamas ahamas arbados D arbados ominica arbados ominica ahamas D

6 COUNTRIES IN ACTION DIVISION OF AGEING, TRINIDAD&TOBAGO MÓNICA CUEVAS GUYANA Preparing a policy The Government of Guyana is preparing a policy document on the elderly. Concern has been raised on the quality of service offered to the elderly and the need to address it in a comprehensive manner. As such a National Commission has been established to determine the social, financial and medical needs of the ageing population. Despite the fact that Guyana still has a fairly young population, many provisions are already in place to ensure that the ageing citizens are economically independent and socially included. Through the Social Impact Amelioration Program a number of schemes have been introduced to deal with the situation of the vulnerable and older population. Old age pensions are provided to all persons age 65 and over and delivered to disabled pensioners at their homes. In addition, limited access is available to primary health care services including free medication. There has also been the introduction of the Food for the Poor Incorporated programme, which offers food and other items to communities which include the elderly in difficult economic circumstances. The extended family concept still prevails in Guyana, through which the majority of the elderly are taken care of by their families. However, to cater to the rest of the ageing population, there has been the promotion of senior citizens clubs and annual subventions are provided to senior citizens homes. S Guyana G uyana t. Kitts & Nevis JAMAICA Productive ageing In 1997 Jamaica became the first country in the Caribbean region to adopt a National Policy for Senior Citizens. This policy reflects the United Nations International Principles for Older Persons, which places emphasis on independence, participation, care, self fulfillment and dignity. The National Council for Senior Citizens adopted a mission statement in 1997 which partly reads, to meet the challenge of a growing, healthier and more active ageing population by ensuring that senior citizens are able to meet their basic human needs, that those in need are assisted and that older persons are protected from abuse and violence and are treated as a resource and not as a burden... The Council undertakes a variety of programmes and activities arranged into health, income security and education. Given limited resources, the strategies of the National Policy for Senior Citizens are implemented though an island-wide network of senior citizens clubs. Loans and grants for small enterprises, training programmes (including healthy lifestyles, managing finances and creating wills) and referral services are provided with the aid of civil society groups. In an effort to reduce the incidence of poverty among the ageing, a number of initiatives have been introduced. These include a reform of the Social Safety Net in 1999 and a major reform of the Pension System through the introduction of a National Pension Act. J amaica J amaica J amaica ST. KITTS & NEVIS Focus on poverty Subsequent to the writing of a draft policy on ageing, the Government of St. Kitts and Nevis has made changes to some existing policies and implemented new programs geared specifically to benefit the elderly. One such change is the provision of a noncontributory assistance pension for older persons who have not contributed to the social security scheme but are in financial need. Universal access to health care, medication and dental and eye care for citizens over 55 years of age is provided through a network of clinics and health care facilities. A public facility in St. Kitts caters exclusively to the chronically ill, disabled and geriatric cases, and Nevis has a 22 bed infirmary that houses psychiatric patients and the aged poor. In addition, the Home Care Program for Older Persons assists the elderly and disabled in their homes with hot meals, food packages, medical assistance and social interaction. These are all a result of the Government s efforts to ensure the elderly population is provided with adequate health care and services. The Ministry of Social Development, Community and Gender Affairs has been instrumental in establishing the Adopt an Older Person Program which facilitates interaction and collaboration between older citizens and school children throughout the country. S G uyana S t. Kitts & Nevis t. Kitts & Nevis

7 COUNTRIES IN ACTION DIVISION OF AGEING, TRINIDAD&TOBAGO MÓNICA CUEVAS ST. VINCENT & THE GRENADINES Five year strategic plan TRINIDAD & TOBAGO Eight areas of action The Government is actively engaged in formulating a National Policy on Ageing and the development of a Five Year Strategic Plan. However, already in existence are a number of systems and services aimed at ensuring financial stability and guaranteed health care for the older population. The Ministry of Social Development provides a monthly financial contribution of EC $100 for persons under 65 and EC$110 for persons over 65, in addition to immediate cash assistance, medication, help with utility bills, toiletries, food and burials, as may be required. The National Insurance Service (NIS) provides pensions to 4,000 older persons, 2,200 receiving contributory pensions and 1,800 non-contributory. There are plans however to expand this service to the informal sector. Free health services are provided for sufferers of infectious diseases as well as indigent and unemployed persons over 60 years through the Medical Officers Act. HelpAge International and the National Council for Older Persons (NCOP) of St. Vincent & The Grenadines are also conducting research on the situation of older persons. Their findings will contribute to the development of the National Policy on Ageing. S t. Vincent & the Grenadines The Draft National Policy on Ageing was approved in September 2004, identifying eight priority areas for action: social security, income security, social inclusion, healthcare, housing, education, recreation and legislation. A Division of Ageing was established to prepare and implement the National Policy, emphasising communitybased services, dignity, independence, education public awareness on ageing, and access to affordable healthcare for older persons. A Community Care Act is being developed to provide the legal framework for care and protection of the rights of older persons. The Homes for Older Persons Act ensures the licensing, regulation and control of homes for the elderly. The Government provides old age pensions. A task force has been established to review the pensions system. There is universal access to health care through an island-wide network of hospitals and clinics. In addition, a Chronic Diseases Assistant Plan has recently been instituted. A Geriatric Adolescent Partnership Program and the Retiree Adolescent Partnership Program have been designed to encourage intergenerational solidarity. T rinidad & Tobago S T t. Vincent & rinidad & the Grenadines Tobago HelpAge International: 24 years empowering older Caribbean Putting ageing at the center of development processes, supporting livelihoods and mitigating the effects of natural disasters are HelpAge International s guidelines for it s work in the Caribbean, which started in A key issue for the goals of the organization is to support older people to advocate for their rights and influence the policies that affect them. For those purposes HelpAge works with local partners, such as the St. Lucia National Council of and for Older Persons, the Old People s Welfare Association, in Montserrat; Extended Care Through Hope & Optimism (ECHO), in Grenada, and other English and French speaking organizations in 10 countries. Two concrete main programmes are currently being successfully conducted by HelpAge Caribbean. The Older citizen s monitoring project in Jamaica supports older persons in three poor farming communities to allow them to exercise their right to access to government social-protection programmes, and lobby the authorities for improvements. The Caribbean is a subregion with high risk of natural catastrophes hurricanes, floods, earthquakes and volcanic eruptions-, and older people are particularly vulnerable in these extreme situations. HelpAge developed the project Preparing older people and their communities for disasters, which enables older persons and other community members to work together, protect themselves and help others in case of natural catastrophes.

8 EVENTS Montevideo: ECLAC called the attention of countries on social protection The last Session of the Commission was focused on the need of a new rights-based social covenant. Course in Social Gerontology (Summer Programme) Department of Behavioural Sciences of the University of the West Indies Trinidad&Tobago June-July 2006 (Registration in May 2006) Contact: Innette Cambridge ImCambridge@fss.uwi.tt Third National Forum Toward a Culture of Healthy Ageing Dirección de Personas Adultas Mayores, Ministerio de la Mujer y Desarrollo Social Lima, Perú. May 2006 Contact: Doris Dionisio ddionisio@mimdes.gob.pe First National Conference on the Rights of Older Persons Conselho Nacional dos Direitos do Idoso Brasilia, Brazil. May Contact: Jurilza Barros de Mendonça jurilza.mendonca@sedh.gov.br Simposium Ageing and the Social Construction of Age: Theorical Approaches and Analitical- Methodological Units 52 Congreso Internacional de Americanistas Sevilla, Spain. July 17th-21st, Contact: Sandra Huenchuan sandra.huenchuan@cepal.org Gericuba 2006 IV Iberoamerican Congress on Gerontology and Geriatrics, V Central American and Caribbean Congress on Gerontology and Geriatrics, XIII International Seminar on Attention to the Older Adult, V International Meeting of Older Persons Havana, Cuba. May 2nd - 5th (simultaneous translation available) Contact: congresogericuba2006@infomed.sld.cu O ne of the most challenging problems faced by the Latinamerican and Caribbean countries beginning the new millennium is to cope with the vulnerable situation under which a large proportion of the population lives because of the fragility of the social security systems. With differences from one country to other and with particularities in the Englishspeaking Caribbean, where social security systems are rather young-, low coverage, fragmentation, deficient quality, limited access and the trend to rely on contributory mechanisms that do not address the extended labour informalityare common in the region. And the consequences of it are by and large visible throughout the lives of the citizens, especially among the aged. Social protection was the central issue of the last ECLAC Session, held in Montevideo from March 20 th to 24 th. The discussions were focused in the need of a new approach to social protection, given the structural changes the region is experiencing in its age structures, labour markets and family dynamics, among others. This approach, as raised at the meeting, should be the result of a new rights-based social covenant, in which social rights are seen as the normative horizon, and existing inequalities and budgetary restrictions are the limiting factors to be addressed. During the meeting, the Secretary General launched the document Shaping the future of social protection: access, financing and solidarity, in which ECLAC proposes a framework of integral solidarity that combines contributory and no contributory mechanisms and places emphasis on an efficient use of the resources, with a view to expanding the coverage and raising the quality of services, especially for the lowest-income sectors of the population. The need to incorporate the gender perspective in social protection policies was also underlined in Montevideo. The challenge for the region is to build bridges between social rights and policy guidelines in order to make them more enforceable through improved access, better financing and greater solidarity. On this purpose ECLAC called special attention the reform and design of health and pension systems, taking into In the new rights-based social covenant proposed by ECLAC, social rights should be the normative horizon. consideration the labour market dynamics and the countries' fiscal capacities. A number of countries have made advances in the right direction. Bolivia introduced universal pensions through the Bonosol; Costa Rica improved women s position in the welfare system by conferring a value to unpaid domestic work in terms of contributions. Belize has put in place a non-contributory pension for all women over 65. These are a few evidences of the momentum that the social protection debate is gathering in the region. The new ECLAC document and the discussions generated by it in Montevideo are expected to generate fruitful debates at the national level.

9 CIVIL SOCIETY KAROLINE SCHMID Yvonne O Neill: It is necessary to make senior groups available to more people Secretary Senior Achievers Association of Trinidad and Tobago says, organized elderly need to do outreach drives to raise awareness on ageing. Y vonne O Neill runs the Woodbrook branch of the CHOICES organization, which is a day care and education centre for pregnant teens and teenage mothers and their babies. But that doesn t seem to be enough for her free spirit, strong will and desire to maintain a youthful heart and mind. She is also Secretary of the Senior Achievers Association of Trinidad and Tobago (SAATT), a vibrant, diverse nongovernmental organization of about 100 retired persons, with a mission to provide a forum for members and friends to enhance the quality of their lives. An objective of the association is to instill in members their importance and usefulness in their community as a result of their age and experience. do outreach drives to religious organizations, community groups and public and private companies in order to raise awareness at an early age, maybe 40 or 50. If you had an audience with the Prime Minister, what would be the most important issue you would like to address? The need for social and recreational homes for the elderly. There should be the construction of senior citizen complexes, where elderly persons can go on a daily basis to engage in social and recreational activities with each other. The complex can force through the Child Welfare League. What importance do you see in the organization of elderly people? It is important to be organized to raise ageing issues. However, not enough older people are involved with groups such as the SAATT. In order to get more seniors engaged I think it is necessary to make senior groups available to more people. As it stands now there are a few organizations functioning for certain categories of people -retired teachers, civil servants and Government Functioning groups need to do outreach drives to religious organizations, community groups and public and private companies in order to raise awareness at an early age. What are your main activities? We are involved in community projects both locally and regionally, for example we give a scholarship of $1,200 per term to a high school boy and we donated funds to Haiti and Grenada after natural disasters. We also visit other Caribbean countries, go on cruises and have Know Your Country tours. Since we receive no Government assistance, we hold many fund raising activities: tea parties, an annual carnival party, a market day/breakfast and bar-bques. In addition, at some of our monthly meetings individuals are invited to lecture on various topics including financial management, preparation of wills, heart ailments and Alzheimer s disease. What are the critical issues on ageing in Trinidad and Tobago? A lack of awareness that our society is ageing. If people are aware of this situation, they need to get involved. There are too many seniors just sitting around. I suggest that functioning groups need to be constructed with apartments on the upper levels, which can be rented to those seniors who can afford them, and that income can be used to offset the cost of running the recreational activities. The Prime Minister is ageing as well, he should recognise the need for senior homes and allocate spaces for construction in the north, south and Tobago. Do you think some older people s failure to keep active once they retire is a function of society? I think it may be a loss of will or pride, or due to illness. Some people age with illness and can not function like they used to, so they remove themselves from active society. What is your motivation for being involved in this organization? I retired at age 52 and after a few months of relaxing I decided that I did not want to sit at home doing nothing. So I joined the SAATT and also got back into the work pensioners-, but many more seniors who do not fall into those categories do not have access to an elderly group or organization they can be a part of. How do you evaluate the efforts of the Government of Trinidad and Tobago to accomplish the goals of Madrid 2002? The Government is looking at dealing with issues of ageing but so far not enough has been done. There has been the establishment of the Division of Ageing, which has an extremely committed and hard working director, however I don t think Government is providing the necessary funds and facilities for it to function effectively. What advice would you give to a younger person to prepare for older age? Ageing is inevitable, go to the gym, keep a fresh mind, hang around with young people. Get involved in groups, do things that make sense, make others aware, keep active and keep happy.

10 AGEING AROUND THE WORLD United States and Canada: The benefits and challenges of development AoA In North America, although most older people enjoy well-being, there are vulnerable groups needing attention. N early 60 million people aged 60 or over live in North America, possibly the most developed region in the western world, with the United States and Canada members of the G-8, the group of the eight most industrialized countries on the world. To this end, the Government established a National Seniors Secretariat to be responsible for ascertaining the wellbeing of elderly men and women, not only from the financial point of view, but also as regards health, security, social isolation and community-based support. A report prepared by the Federal Interagency Forum on Aging Related Statistics found that the majority of older persons were healthier, better educated and enjoyed a better quality of life than their peers of earlier generations. The report did warn of inequalities, however. The majority of North American adults have benefited from development. The region has social protection systems with broad coverage and community support structures that meet many of the needs of the elderly. However, there are vulnerable groups which pose special challenges, such as immigrants and war veterans. In both Canada and the United States, civil society is an important ally in dealing with the question of ageing. Both countries enjoy a tradition of civic organization, a trait which includes the elderly, who have been active in forming community groups. Canada appears to be well placed to face the process of demographic change. It has a solid fiscal base and has set up a series of programmes for its elderly population. Furthermore, Canada s pension system is one of the world s most successful as regards the effort to avoid poverty in old age; in fact, the number of low-income elderly in Canada is among the lowest of any of the Organisation for Economic Cooperation and Development (OECD) countries. Nationwide, older Canadians have a lower probability of receiving a low income than other age groups do. The challenge for policymakers is to make headway in terms of health and well-being, with emphasis on vulnerable groups, such as older people living alone, those managing on low incomes and immigrants. In the area of health, the Federal Government, together with the Division of Aging and Seniors (DAS), has taken measures to enhance the well-being and independence of older persons through the promotion of active ageing and physical and mental health and the In both Canada and the United States, civil society is an important ally in dealing with the question of ageing. prevention of falls. On this last point, DAS is cooperating with the World Health Organization to raise awareness of the impact that such falls can have on older persons quality of life and independence. Canada is endeavouring to make a global contribution in the design of guidelines for disasters and emergencies, during which older people are vulnerable. In the United States, Administration on Aging, the federal organization responsible for older persons affairs, has worked for over 40 years on maintaining the independence of the elderly. This line of government action has been successful in offering elderly people community-based services, promotional and preventive health programmes and initiatives to provide carers with services and support. The broad coverage and good quality of these services are well rated by their users. For example, 76% of white non-hispanic older people had a complete school education, but only 52% of older Afrodescendent and 35% of older Hispanics had finished the school. Elderly are financially better-off too. Between 1984 and 2001, the average net income of households headed by people aged over 65 increased by 82%. However, households headed by a white older person have an annual income five times large thant the households headed by an Afro-descendent older person. The effort to devise creative ways to improve the situation and promote the well-being of vulnerable groups of older persons is a priority being addressed by an extensive network of governmental and non-governmental organizations concerned with population ageing. Websites of interest Division of Aging and Seniors National Advisory Council on Aging Administration on Aging Federal Interagency Forum on Aging Related Statistics

11 AGEING AROUND THE WORLD DIVISION OF AGING AND SENIORS, CANADA Ageing statistics: Two realities on the same side of the world The proportion of older adults living in North America it twice as large as in Latin America and the Caribbean. Northern America Latin America and the Caribbean Proportion of Older Persons (60 +) Median age Fertility rates Children per woman ,3 25,9 41,5 39,9 1,98 1,85 Life expectancy at birth General Men Women 2,38 1,86 General 78,2 72,9 Men Women 75,5 80,8 69,8 76,1 Northern America Latin America and the Caribbean Population over 100 years old (in thousands) ,8% 27% 8,8% Men Women Both Northern America 24,1% General General 82,7 79,5 Men Women Men Women 80,2 85,2 76,4 82, Latin America and the Caribbean Old-age dependency ratio Number of persons over 65 per 100 persons in working age (14-64)

12 INTER-INSTITUTIONAL GROUP ON AGEING Alexandre Sidorenko: Talking to older persons is the essence of the bottom-up approach United Nations Focal Point on Ageing underlines the importance of participation in the review and appraisal process of Madrid+5. When the First World Assembly on Ageing took place in Vienna in 1982, Dr. Alexandre Sidorenko had already been four years conducting experimental research at the Kiev Institute of Gerontology. Those were the first steps of a prominent career in the field of ageing, which included the organization of the International Year of Older Persons (1999) and the Second World Assembly on Ageing, in Madrid (2002). Today, as the United Nations Focal Point on Ageing, his energies are set on promoting and monitoring international policy and programmes on ageing, and to this point of time, on the review and appraisal process, starting next year. What s your global evaluation four years after the Second World Assembly? It is difficult to answer this question now. The site of action in the implementation of the Madrid International Plan of Action on Ageing (MIPAA) are the national and local levels; the review and appraisal exercise scheduled to begin in 2007 will show the achievements and obstacles. "The mechanisms of participatory assessment mean meeting in focus groups to find out what the feelings and thinking of ordinary people are about the changes in their quality of life". Do you think there is enough awareness on ageing in the international community? Every United Nations organization is undertaking action on the field of ageing, within the scopes of their mandates, their professional interest and qualifications. WHO is putting forward many projects, including their major policy background on active ageing; ILO is looking in employment in the older age; World Bank is working on the pensions reform and providing advisory services to member states On the other side, important UN documents, like the Millennium Declaration do not mention ageing. Do you see a contradiction in this? There is definitely a contradiction, but also